Application Cycle for HMDCB Exam Now Open

The application cycle for the 2017 Hospice Medical Director Certification Board (HMDCB) exam is now open through March 21, 2017. Nearly 650 individuals from across the country have already been certified in the organization’s first three exam cycles.

So why is physician certification important? According to Suzanne Karefa-Johnson, MD HMDC, a Physician at Hospice of the Comforter in Altamonte Springs, FL, "The HMDCB certification program is an important avenue to establishing one's expertise in the administrative and clinical skillset demanded of a hospice medical director. It helps to affirm the importance of physicians providing end-of-life care within the larger palliative and medical continuum of care."

In addition, initial physician certification and the continuing education required to maintain certification contribute to the creation of an environment of professionalism and a culture of retention — a critical issue for hospices today. Certification is also a vehicle for hospices to differentiate themselves from competitors and demonstrate to consumers that they have attracted the most skilled and experienced healthcare professionals.

By visiting HMDCB’s Physician and CEO pages on its website, you can learn more about the benefits of applying and watch two videos featuring hospice colleagues who share why the certification is valuable. 

The early bird application deadline for the Hospice Medical Director Certification Board’s 2017 exam is Tuesday, February 28. Applicants who complete their application before the deadline save $250! 

Medicare Advantage and Hospice

Guest Blog
by Jay Cushman, HealthPivots

The State Hospice Profile™, available from NHPCO, summarizes the use of hospice services by Medicare beneficiaries since 2000.  This chart of the Hospice Penetration Rate, from the National Profile page, shows that enrollees in Medicare HMO plans use hospice at a much higher rate than average.

In 2015, the Penetration Rate for Medicare HMO enrollees was 82% compared to 68% for all Medicare beneficiaries.  In the State Hospice Profile™, Penetration Rate is defined as the ratio of Medicare Hospice Patients Served to Total Medicare Deaths.  The source for these data is the Medicare claims standard analytic files that contain information on beneficiary demographics, deaths, and hospice use. 

Medicare began paying for services for enrollees in 1966, and hospice services were included in the Medicare benefit package in 1983.  In 1997, private insurance plans were included in the Medicare program.   These plans are now collectively called Medicare Advantage as distinguished from Original Medicare which is also called Fee-for-Service (FFS) Medicare.   Medicare Advantage plans are also sometimes called Medicare HMO plans.  Medicare Advantage plans must cover all the services that Original Medicare covers, except hospice care.  If a Medicare Advantage enrollee elects hospice, payments for both hospice and other services are made by Original Medicare.  

However, in 2014, the Medicare Payment Advisory Commission (MedPAC) recommended that Congress should include the Medicare hospice benefit in the Medicare Advantage benefits package.

This change, if implemented, would affect a significant and growing portion of the Medicare enrollees who now choose hospice care.

Since 2004, practically all the growth in Medicare beneficiaries and Medicare deaths has been captured by the growth in Medicare Advantage plans.

Another measure of hospice use is the Death Service Ratio, defined as the ratio between Medicare Hospice Deaths and Total Medicare Deaths. This ratio for Medicare Advantage has significantly exceeded the ratio for Original Medicare.

 This gap is all the more remarkable because Medicare Advantage enrollees are, on average, younger than Original Medicare enrollees.  The use of hospice tends to increase with age even among Medicare beneficiaries.  

Nationally, about one-third of all Medicare beneficiaries were enrolled in Medicare Advantage plans in 2015.  This is more than double the percentage in 2004.

However, in some states the Medicare Advantage enrollment is much higher than average.  In Minnesota, for example, over half of all beneficiaries are enrolled in Medicare Advantage.

These are the facts.  The implication is that any disruption in a hospice’s relationship with its Medicare Advantage patients will have a significant impact on that hospice’s business.

© Health Planning & Development, LLC 2017
www.healthpivots.com

The State Hospice Profile™ for each state is available for purchase from NHPCO's Marketplace.

Disclaimer: Any views or opinions represented by guest authors on the NHPCO blog belong solely to the author and do not necessarily represent the views or opinions of NHPCO.

#MLC17 Adds a Focus on Fund Development

An aging population and a rekindled healthcare financing debate promise continued uncertainty and challenges for the hospice sector. Greater demands for our services, and shifting reimbursement will further amplify the need for revenue diversification and enhancement. Increasingly, not-for-profit hospices are recognizing the necessity of a strong development program – augmenting such traditional activities as memorial gifts, direct mail, and special events; with best practices in leadership engagement and major gifts – all in an effort to grow critical and potentially significant gift income.

Effective fundraising requires planning and investment, and begins with leadership. Understanding and leveraging the unique roles of administrators, board members, staff, and volunteers is a prerequisite for success. Incorporating development objectives in a broader strategic plan calls for vision and advocacy.

For the first time ever, this year’s Management and Leadership Conference will feature a number of educational offerings devoted entirely to fund development. Members of the C-Suite – particularly chief executives, financial officers, and development officers – will all benefit from these sessions. Our faculty of practitioners and consultants from high-performing organizations will present on a wide range of important topics, informing and empowering our attendees to more confidently champion and advance their charitable mission.

Join us!

T. Christian “Chris” Rollins, MBA, CFRE
Chief Development Officer
Samaritan Healthcare & Hospice, Marlton NJ

Prepare for National Healthcare Decisions Day 2017

National Healthcare Decisions Day exists to inspire, educate and empower the public and providers about the importance of advance care planning. For 2017, NHDD will be a week long event, from April 16 to 22. The overall theme for 2017 is "It always seems too early, until it's too late."

In all respects, NHDD is inclusive and brings a variety of players in the larger healthcare/legal/religious community together to work on a common project, to the benefit of patients, families, and providers. NHDD is not prescriptive; it allows for and fosters creativity. A key goal of NHDD is to demystify healthcare decision-making and make the topic of advance care planning inescapable.

Outreach Webinar
Join the outreach team on February 15, 2017 at 3:00 pm EST for a National Healthcare Decisions Day Webinar. This April NHDD supporters look forward to celebrating 10 years of promoting advance care planning conversations across the country. To RSVP for the webinar and access connection instructions, e-mail zrubin@ihi.org.  

 

Hospice Advocacy in 2017

With the Presidential and Congressional elections now behind us and the new administration beginning to get to work, hospice and palliative care leaders must renew their focus on Capitol Hill and educate new and returning policymakers about end-of-life issues. The Hospice Action Network will host two important events on Capitol Hill in 2017, and we need the support and participation of all hospice advocates.

May 3, 2017
NHPCO’s Management and Leadership Conference: Advocacy at MLC – Washington Hilton

NHPCO will host Advocacy at MLC for conference participants on Wednesday, May 3. In the morning, MLC conference attendees will be briefed about the 115th Congress; the new administration; the changing health policy landscape; and NHPCO efforts to preserve, protect, and promote hospice and palliative care. In partnership with the Council of States, participants will take to Capitol Hill that afternoon to advocate in support of NHPCO’s legislative agenda. Register now at www.nhpco.org/mlc2017.

July 17-18, 2017
Hospice Action Network Advocacy Intensive – Hyatt Regency Capitol Hill

Advocacy is not a once-a-year event and it’s important to reinforce our message throughout the year. Hospice and palliative care organizations are encouraged to send members of the IDT to the premier advocacy event for the hospice and palliative care community. Held annually in Washington, DC, the Advocacy Intensive brings together hospice and palliative care professionals, caregivers, leaders, policymakers, and Members of Congress to effect positive change for end-of-life issues. During the two-day event, attendees learn best practices for advocating for hospice and how to connect directly with their members of Congress on Capitol Hill and back in their home districts. Registration will open in Spring 2017.

Be a part of the hospice community's strategic advocacy efforts in 2017.

Attendees at a previous Advocacy Intensive on Capitol Hill.

NHPCO’s New President and CEO

NHPCO announced today that its board of directors has selected Edo Banach, JD, as the organization's next president and chief executive officer, effective February 22, 2017.  Banach will succeed J. Donald Schumacher, PsyD, who has led the organization since 2002.

Banach, currently, is a partner in the firm of Gallagher, Evelius & Jones in Baltimore, MD.  He previously was the Deputy Director of the Medicare-Medicaid Coordination Office at the Centers for Medicare & Medicaid Services and Associate General Counsel at the Visiting Nurse Service of New York.  Prior to that, Banach was the General Counsel at the Medicare Rights Center.

Banach holds a B.A. from Binghamton University and a J.D. from the University of Pennsylvania Law School. Prior to attending law school Banach worked for the New York City Department of Homeless Services and Mayor's Office of Operations.

Edo Banach

“With the aging of the Baby-Boomers, our nation is experiencing an increase in the need for hospice and palliative care services. What began fifty years ago as a grassroots movement to better care for the dying is now an integral part of the U.S. healthcare landscape and the expansion of community-based palliative care services provides further opportunities to ensure we are providing the best possible care for those facing serious and life-limiting illness,” said Banach.
 

“Hospice in the 21^st Century must combine the core hospice philosophy with a laser-like focus on quality and access to care.  Hospice and palliative care must always be focused on patient and caregiver needs, and must be compliant with all federal and state laws and rules. I am honored to join NHPCO at this important time, and look forward to working with NHPCO and its partners on building a better, fairer and more accessible healthcare system,” Banach remarked.

The selection of Banach as NHPCO’s new president and CEO caps a thorough and year-long search process utilizing a nationally recognized recruitment firm. See the full NHPCO press release.

Week one of the 115th Congress

They're baaaaaack!  The 115th Congress was sworn in this past Tuesday (01/03/17) and immediately started causing trouble. The first thing the House of Representatives did was take up a rules package that included a provision to gut the Office of Congressional Ethics. Following a campaign season that promised to “Drain the Swamp,” this was an interesting choice for a first vote.

Needless to say, social media erupted on Tuesday, and thousands of Americans overloaded the Capitol switchboard and servers to complain about the proposed rule. President-elect Trump turned up the heat when he tweeted, “With all that Congress has to work on, do they really have to make the weakening of the Independent Ethics Watchdog, as unfair as it.” Facing the mounting pressure, House Republicans scuttled the proposed rule change, promising to revisit it later, possibly in cooperation with House Democrats.

So why is this important to the hospice community? Well, if nothing else, it demonstrates the importance of paying close attention to the legislative process, and the power that voters can have when they organize and mobilize. In the years before the interwebs, this type of change likely would have slid by, unnoticed by most Americans. You have a voice, you have a mouse, and you have a platform – you can use them to great effect, especially for the hospice community.

So what else have we been up to? Well, the HAN team put out our  What to Expect in 2017 Policy Points Video, prognosticating on what we think will happen over the next few months. A good amount of speculation, but hopefully some good information for you to tuck away. Take the 7 minutes to listen – we think it’ll be worth your time.

We also recently sent a letter to President-elect Trump, introducing him to our community and our key policy priorities. It is a broad-brush overview, but we plan to dive in to the details with his team as they settle into their new positions over the coming months. You can read it here.

So that’s about it for now. Check back regularly, as we will be posting more about the Trump Administration as we near Inauguration Day and as he assumes the Presidency.

By Sharon Pearce
NHPCO Vice President, Public Policy